Filling out the Caption on your form

“Attorney or Party without Attorney” - if you do not have an attorney, fill in your name, address, and telephone number.

If you would like the court to communicate with you by fax or email, you may give them that contact information, but you do not have to.

“Attorney For (Name)” – if you do not have an attorney, write “self represented.”

“SUPERIOR COURT OF CALIFORNIA, COUNTY OF” – write the name of the County where you are filing your case. Click here for location of courts.

“Petitioner” – The person that filled out the first form to start the case. Write that person’s name here.

"Respondent” – The other parent is called the Respondent. Write that person’s name here.

This is the TITLE of the form. Leave as is.

“For Court Use Only” – Leave blank.

“Case Number” – Write in the case number.

Filling out the rest of your form

Stipulation to Establish or Modify Child Support and Order

1. Net monthly disposable income

Check either box “a” or box “b”:

Check this box and enter the “net monthly disposable income” for each parent;

OR

Check this box and attach a copy of a printout of a computer calculation of the parents’ financial circumstances.

2. Timeshare percentage

Check this box and write the percent of time that each parent has primary responsibility for the child.

The Family Law Facilitator in your county can help you work out both the net monthly disposable income and the timeshare percentage for each parent. They also have computer programs that will calculate California guideline child support.

3. Hardship

Mother – Check this box if the mother has an “extreme financial hardship” (as defined by California Family Code, Section 4059 (g)). Write the monthly amount of the qualifying hardship expense, what it is for, and the date you think the hardship expense will end.

Father – Check this box if the father has an “extreme financial hardship” (as defined by California Family Code, Section 4059 (g)). Write the monthly amount of the qualifying hardship expense, what it is for, and the date you think the hardship expense will end.

4. The amount of child support payable by

Write the name of the parent who will be paying the child support, and what the guideline amount of the child support is.

The guideline formula is explained in California Family Code, Section 4055. There are computer programs that calculate California guideline child support. You can contact a private attorney for assistance, or the Family Law Facilitator’s Office at the court. Note: Even if you and the other parent do not agree to the guideline support amount, the law requires that you understand what the guideline support amount is before you agree to something different from it.

5. We agree to guideline support.

Check this box if you and the other parent agree to the guideline child support amount.

6. The guideline amount should be rebutted because…

Check this box if you and the other parent are agreeing to an amount different from the guideline child support amount, and write why the guideline amount should not be used.

If you are agreeing to an amount different than the guideline support, check this box and write in the amount you and the other parent are agreeing to as child support.

Read this section carefully - by signing this form, you and the other parent are agreeing that this amount is in the child’s best interest, that the child’s needs will be met, and that the guideline amount would be unjust or inappropriate

If there are other reasons for why the guideline amount should not be used, check this box and write those factors here.

7. Obligor must pay child support as follows beginning (date)

Write the date that the child support payments should start.

BASIC CHILD SUPPORTChild's name, Monthly amount, Payable to (name) Write the full name of each child that the child support payments are for, the monthly amount for each child, and the name of the person to whom the child support payment should be made.

Total: $ – Write the total monthly child support amount. Then, check the first box if it is due on the first of the month. If it is due on a different day, check the box for “other” and write in the day that the support will be due.

In addition obligor must pay… – Check this box if there are additional reasonable and necessary monthly expenses related to the child that should be added onto the basic child support amount above. Also check the box next to each category of expense that you are adding onto the basic child support amount (child care, health care costs, special educational or other needs of the child, or “other”). Write the name of the person who should receive the payment, and the date that it is due each month.

Total monthly child support payable by obligor will be: $ – Write the total monthly child support amount (the basic child support amount from “7a” plus the add-ons from “7b”). Then, check the first box if it is due on the first day of the month. If it is due on a different day, check the box for “other” and write in the day that the support will be due.

At the top of page 2, FL-350

Fill out the caption boxes as follows:

Write the full names of the petitioner and respondent (you and the other parent.)

Case Number: Write in the case number. (the same number as on page 1)

8. Health Insurance

Write the name of the parent who will maintain health insurance for the children. (That parent must keep providing insurance even after the child has grown up if the son or daughter can’t work because of a physically or mentally disabling injury, illness, or condition and is dependent on the parent for support.)

Check this box to acknowledge that – if health insurance is available at a reasonable cost, through your job or otherwise - you may be required to provide the child’s health insurance coverage.

If the children have health-care costs that are not covered by insurance, you must show here how you and the other parent will share these health-care costs. Write the percentage for which each parent will be responsible.

9. Income Withholding for Support

An earning assignment order is issued.

All Child Support Orders must include an Order assigning the wages of the person paying the support to the person receiving the support. (See California Family Code, Section 5230.) This order must be served to the paying parent’s employer.

The Family Law Facilitator’s Office can help you with this. If you have a case open with the Department of Child Support Services to collect support, they will do the earning assignment for you.

Check this box if you and the other parent agree to not have the earnings assignment (often called “wage assignment” ) served upon the paying parent’s employer. You must explain here how the payments will be made instead (for example, the paying parent is to automatically deposit funds into the receiving parent’s account).

10. Fees for using a private child support collector

If the receiving parent hires a private child support collector, the paying parent must pay all fees for using this service. (This fee can’t be more than one-third of the total amount of the unpaid child support.)

11. Travel expenses for visitation will be shared

Check this box if you and the other parent are agreeing to split any travel expenses that are necessary for the non-custodial parent’s visitation with the children. Write down what percentage of the expenses each parent will pay.

12. Change of address or employment

Check this box to show that you and the other parent agree to let each other know immediately if you move or change jobs. You will give the other parent your new employer’s name, address and telephone number.

13. Other (specify)

Check this box if there are any other terms to your agreement with the other parent. Write them here.

14.

This asks you to confirm that you and the other parent both understand your rights regarding the California child support guidelines, and that the person receiving support under the guideline formula has a right to receive that guideline support amount.

If you feel you do not understand your rights regarding the California child support guidelines, you may want to contact an attorney with experience in this area of law. The Family Law Facilitator’s Office at the court can also explain your rights to you.

15.

This asks you to confirm that you and the other parent are signing this agreement because you want to, and neither one of you are being forced to enter into this agreement.

16. The right to support.

These are questions about public assistance.

Check this box if there is no case open with any governmental agency, such as the Department of Child Support Services, to collect support for the children, and neither parent has applied to receive public assistance for the children.

Check this box if there is a case open with any governmental agency, such as the Department of Child Support Services, to collect support for the children, or if either parent has applied to receive public assistance for the children. Write the name of the county where your case is here.

Note: If you checked this box, you must take this form to the local child support agency (Department of Child Support Services) and have one of their attorneys sign this form here.

The Petitioner must write the date that he or she signs this form, type or print his or her full name, and sign the form.

The Respondent must write the date that he or she signs this form, type or print his or her full name, and sign the form.

If the Petitioner has an attorney, the attorney must write the date that he or she signs this form, type or print his or her full name, and sign the form.

If the Respondent has an attorney, the attorney must write the date that he or she signs this form, type or print his or her full name, and sign the form. THE COURT ORDERS – Leave this section blank for the court to fill out.